The squeaking hip: a phenomenon of ceramic-on-ceramic total hip arthroplasty.

Background: Early reports on modern ceramic-on-ceramic total hip replacements have demonstrated excellent clinical and radiographic results with few cases of catastrophic failure, which, in the case of earlier designs, often had been caused by implant fracture. Several reports, however, have noted the presence of audible squeaking. The purpose of the present study was to determine the incidence of squeaking in association with the use of this bearing couple.

Management of distal humerus fractures with minifragment fixation.

Minifragment implants provide several advantages for the stabilization of distal humerus fractures. Compared with small fragment implants, minifragment implants may provide enhanced fracture fixation because a greater number of screws can be placed into the distal fragments. In addition, minifragment plates are easier to contour and less prominent.

A salvage procedure for refractory shoulder instability.

We present the case of a patient with symptomatic refractory multidirectional shoulder instability who was treated with staged bilateral anterior and posterior glenoid bone augmentation after previous failed arthroscopic and open procedures. The patient was pain free postoperatively and has not had symptoms of instability in either shoulder. At her most recent followup, 24 months after surgery, she had nearly full symmetric shoulder range of motion without anterior or posterior apprehension signs.

Metacarpal fractures in athletes: treatment, rehabilitation, and safe early return to play.

Specialty gloves and buddy taping of adjacent fingers may cushion impact and dissipate twisting forces so that hands, thumbs, and fingers are protected during play. When fractures occur, athletes must be protected from contact until healing has progressed to a point where reinjury or complications are unlikely and performance standards and expectations can be met. This article outlines a program of fracture management principles and progressive graduated rehabilitation that phase the hand-injured athlete first into general conditioning and non-ball-handling drills, then into return to hand impact activities, body contact, ball handling, and catching with the use of protective hand gear.

Complicated femoral shaft fractures.

The treatment of femoral shaft fractures has become safe and reproducible since the advent of popularization of intramedullary nailing, however, many femoral shaft fractures are complicated by associated fractures, extensive comminution, extensive contamination, and arterial injury compartmental syndrome. Other conditions associated with the use of femoral nailing include femora nonunions, broken hardware, acute fractures with prior implants, and infections. The management of these complex femoral shaft fractures demands special techniques for successful outcome.